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Different Characteristics between Patients with Apical and Non-Apical Subtypes of Stress-Induced Cardiomyopathy
Journal of Cardiovascular Ultrasound ; : 116-122, 2013.
Article in English | WPRIM | ID: wpr-54464
ABSTRACT

BACKGROUND:

Stress-induced cardiomyopathy (SCM) is characterized by apical ballooning on echocardiography, but some of SCM patients show non-apical involvement and their characteristics are not well defined.

METHODS:

We investigated 56 patients that were diagnosed as SCM and divided them into 2 groups apical ballooning syndrome (ABS, n = 49, 87.5%) and non-apical ballooning syndrome (N-ABS, n = 7, 12.5%) groups. Patients with N-ABS were significantly younger than those of the ABS group (52 +/- 11 vs. 73 +/- 10 years, p < 0.001).

RESULTS:

Types of preceding stressors and clinical presentation including chest pain, pulmonary edema, cardiogenic shock and in-hospital mortality were comparable between the two groups. In the N-ABS group, wall motion score index was significantly lower than in the ABS group (1.61 +/- 0.35 vs. 1.93 +/- 0.31, p = 0.016). On electrocardiogram (ECG), T-wave inversion (57.1% vs. 95.8%, p < 0.001) were less frequent in the N-ABS than in the ABS group. Furthermore, maximum QT and corrected QT (QTc) intervals in the N-ABS patients were significantly shorter than the ABS patients (QT, 419.9 +/- 66.1 vs. 487.3 +/- 79.6 ms, p = 0.038; QTc, 479.0 +/- 61.9 vs. 568.0 +/- 50.5 ms, p < 0.001).

CONCLUSION:

Patients with the N-ABS showed not only atypical echocardiographic findings, but also atypical clinical and ECG manifestations. Integrated consideration is needed to reach a diagnosis of the non-apical subtype of SCM.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Pulmonary Edema / Shock, Cardiogenic / Chest Pain / Echocardiography / Hospital Mortality / Electrocardiography / Takotsubo Cardiomyopathy Limits: Humans Language: English Journal: Journal of Cardiovascular Ultrasound Year: 2013 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Pulmonary Edema / Shock, Cardiogenic / Chest Pain / Echocardiography / Hospital Mortality / Electrocardiography / Takotsubo Cardiomyopathy Limits: Humans Language: English Journal: Journal of Cardiovascular Ultrasound Year: 2013 Type: Article